Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Problems with the comb occupy the 5th place in the structure of all diseases of the musculoskeletal system. They are more common in people over the age of 45. Timely diagnosis and initiation of therapy can slow the progression of the disease.
Development mechanism
Degenerative-dystrophic pathology, which also includes osteochondrosis, is characterized by the presence of several main links in the pathological process, including:
- Malnutrition (tropism) of cartilage tissue that occurs against the background of excessive stress or exposure to other provoking factors is called dystrophy.
- The gradual destruction of cells and intercellular substance of cartilage tissue that occurs as a result of malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of cartilage tissue.
- Violation of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the processes of the ridge in different parts. The intervertebral discs between the vertebrae are flattened, which leads to a compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of development of the disease is always accompanied by neurological symptoms.
Causes of the disease
Chest osteochondrosis is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered by the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional properties of cartilage tissue with subsequent disorders against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and abnormalities in the development of the structures of the musculoskeletal system, which lead to changes in the flow of blood in tissues and a deterioration in the nutrition of cartilage components.
- Postponed injuries to various parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the ratio of various structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), which leads to congestion in the tissue.
- Systematically increased stress on the thoracic spine (hard physical work, persistent static load).
- Disruption of mineral salt metabolism in the body, which provokes a decrease in the strength of bone processes, intervertebral discs and the subsequent malnutrition of cartilage structures.
- Deterioration in blood supply to the tissues of the spine, which occurs against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular poisons that cause a deterioration in blood flow to tissues and a violation of their diet.
Determining the reasons for the development of the pathological process is an integral part of the diagnostic process. This is necessary for the subsequent appointment of an effective treatment, as well as the prevention of the new development of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of the degenerative-dystrophic process is accompanied by the appearance and subsequent increase in the intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest - initially pain occurs after exertion, a long stay of the human body in one position. Then the feelings of discomfort intensify and become permanent. Often the pathological process is accompanied by a dull, sore back pain between the shoulder blades.
- Uncomfortable "squeezing" feeling in the back, which means that you cannot breathe in fully.
- Injury to skin sensitivity in the form of numbness in different parts of the body (changes cover the skin of the upper or lower extremities on one side of the body) due to compression of the sensitive nerve fibers of the roots of the spinal cord.
- Muscle weakness in one arm or leg is usually on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by belching, heartburn, abdominal pain, flatulence (bloating), unstable bowel movements.
- Changes in the back and arms, including dry skin, increased fragility of the nails (the result of a violation of the state of the autonomic nerve fibers when squeezing the spinal root).
- Changes in the functional state of the pelvic organs, which are manifested in impaired urination, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, a person can not accurately specify the timing of their development. For a long time the intensity of symptoms increases, new signs of the pathological process appear. Due to the type and duration of back pain, there are 2 types of pain in thoracic osteochondrosis:
- Dorsago pain manifests itself in the form of seizures that limit movement in the back and impair breathing.
- Dorsalgia is a constant aching pain localized in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and a decrease in human quality of life. Depending on the degree of changes, 4 stages of the development of pathology are distinguished:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2 - bulging (flattening) of the intervertebral disc, the appearance of slight pain, mainly after exertion.
- Stage 3 - the formation of a herniated disc, violation of the root of the spinal cord, constant pain occurs, neurological symptoms develop.
- Stage 4 - pronounced changes that lead to severe constant pain, numbness of the skin in various parts of the body, decrease in muscle strength, mainly in the upper limbs.
Determination of the stage of the pathological process is made on the basis of the clinical manifestations of the disease. In order to clarify the type and severity of the changes, an objective diagnosis with imaging procedures of the spine is also prescribed.
diagnosis
Based on the clinical picture, the doctor draws an initial conclusion. To determine the localization and nature of the change, as well as the stage of the pathological process, an additional examination with visualization of the chest is prescribed:
- The X-ray of the spine is the most common method of instrumental diagnostics, which allows you to detect gross changes in the structures of the spine.
- Computed tomography is an X-ray technique of layer-by-layer tissue scanning, which has a high separation efficiency and makes minimal changes in the chest visible.
- Magnetic resonance imaging - for visualization, the resonance phenomenon of the cores of compounds, which occurs in a magnetic field, is used. The technique involves scanning the body while the human body is not exposed to radiation.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical, biochemical blood test, urine test). After the diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
Treatment of osteochondrosis of the thoracic spine is always complex. It is aimed at restoring the nutrition of cartilage components, normalizing their properties, as well as the functional state of the vertebrae and roots of the spinal cord. Two main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical procedure.
Often both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs of several groups:
- Nonsteroidal Anti-Inflammatory Drugs - Reduce the severity of the inflammatory response and pain.
- Adrenal Hormones - Reduce inflammation and neurological pain.
- Muscle Relaxants - Drugs reduce the tone of the striated muscles in the spine, thereby reducing the compression of the roots of the spinal cord.
- Diuretics - means a decrease in tissue swelling and compression of the roots of the spinal cord due to increased excretion of urine.
- Chondroprotectors - reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the flow of metabolic processes in nervous tissue, contribute to the early restoration of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens the blood vessels, has an antioxidant effect (binds and inactivates free radicals, which are "fragments" of organic molecules with an unpaired electron and which damage the membrane structures of cells).
During remission (improving the condition and reducing acute symptoms of inflammation), exercise therapy (physical therapy exercises with special exercises), back massage, physiotherapeutic procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. When carrying out therapeutic measures, it is important to follow dietary (refusal of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest) recommendations. Conservative therapy enables a significant improvement in the condition.
Surgical interventions
In the absence of the necessary therapeutic result against the background of the use of drugs, as the pathological process progresses, in order to radically eliminate the problems, invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc followed by plastic of the hernial opening.
- Foraminectomy - removal of excess bones that narrow the canal in the area where the roots of the spinal cord exit.
- Laminectomy is an expansion of the canal of the exit area of the spinal roots.
In modern hospitals, minimally invasive endoscopic techniques are used. For the plastic opening of the hernial opening, special nets made of hard-wearing material that do not cause any inflammatory reactions are usually used.
prevention
To prevent the development of a pathological process, you need to follow several simple preventive recommendations, including:
- Sufficient eight hours of sleep.
- Limitation of the effect of stressors (chronic stress can provoke the development of pathological processes).
- Normalization of the regime of work and rest.
- Restriction of heavy physical work.
- Rejection of bad habits.
- Rational diet with sufficient intake of vitamins and vegetable fiber.
- Sufficient motor regime with dynamic exercises (recharging), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronically progressive course. The disease requires long-term therapy, so it is easier and more accessible to prevent its development.